Radiation Oncology/Testis/Staging

AJCC 7th Edition (2009)
Primary Tumor:

T1 - limited to testis and epididymis without vascular/lymphatic invasion; may invade into the tunica albuginea but not the tunica vaginalis
T2 - limited to testis and epididymis with vascular/lymphatic invasion; or tumor involving the tunica vaginalis
T3 - invades the spermatic cord
T4 - invades the scrotum

Regional Lymph Nodes:

Regional nodes: para-aortic, interaortocaval, para/pre/retrocaval, pre/retroaortic LN

Intrapelvic, external iliac, and inguinal LN are considered regional only after scrotal or inguinal surgery.

Clinical:

N1 - lymph node mass 2 cm or less in greatest dimension; or multiple lymph nodes, none more than 2 cm in greatest dimension
N2 - lymph node mass 2 - 5 cm; or multiple lymph nodes, any one mass 2 - 5 cm
N3 - lymph node mass > 5 cm

Pathologic:

N1 - lymph node mass 2 cm or less in greatest dimension, and <= 5 nodes positive, none more than 2 cm in greatest dimension
N2 - lymph node mass 2 - 5 cm; or more than 5 nodes positive, none more than 5 cm; or evidence of extranodal extension
N3 - lymph node mass > 5 cm

Distant Metastases:

Serum tumor markers (S):

Note: (from the AJCC Staging Manual, 7th Edition) "Serum tumor markers should be measured prior to orchiectomy, but levels after orchiectomy are used for assignment of S category .... Stage grouping classification of Stage IS requires persistent elevation of serum tumor markers following orchiectomy." ^{(* corrected in erratum)}
S0 - serum markers within normal limits
S1 - LDH < 1.5 * upper limit of normal, AND hCG < 5000 mIu/mL, AND AFP < 1000 ng/mL
S2 - LDH 1.5 - 10 * normal range, OR hCG 5000-50,000, OR AFP 1000-10,000
S3 - LDH > 10 * normal range, OR hCG >50,000, OR AFP > 10,000

Stage Grouping:

AJCC 6th Edition (2002)
No changes compared to 7th Edition